Facilitating State Health Exchange Communication Through The Use Of Health Literate Practices

Implementation of the Affordable Care Act (ACA) of 2010 will result in significant changes to the U.S. health care system. Among its many provisions, the ACA will extend access to health care coverage to millions of Americans who have been previously uninsured. Many of the newly eligible health insurance consumers will be individuals of low health literacy, some speakers of English and others more comfortable using languages other than English. Health insurance terms such as "deductible," "co-insurance," and "out-of-pocket limit" are difficult to communicate even to those with moderate-to-high levels of health literacy and so health exchanges will face challenges as they attempt to communicate to the broader community. In addition to having to convey some of these basic, and yet complex, principles of insurance, state exchanges will be attempting to adapt to the many changes to enrollment and eligibility brought about by ACA. The Institute of Medicine (IOM) convened the Roundtable on Health Literacy that brings together leaders from the federal government, foundations, health plans, associations, and private companies to discuss challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. The roundtable sponsored a workshop in Washington, DC, on July 19, 2011, that focused on ways in which health literacy can facilitate state health insurance exchange communication with potential enrollees. The roundtable's workshop focused on four topics: (1) lessons learned from existing state insurance exchanges; (2) the impact of state insurance exchanges on consumers; (3) the relevance of health literacy to health insurance exchanges; and (4) current best practices in developing materials and communicating with consumers. Facilitating State Health Exchange Communication Through the Use of Health Literate Practices summarizes the presentations and discussion that occurred during the workshop. The report provides an overview of health insurance exchanges, presents evidence on the extent to which consumers understand underlying health insurance concepts, and describes the relevancy of health literacy to health insurance reform and how health literacy interventions can facilitate the implementation of health insurance reforms. The report also provides a review of best practices in developing materials and communicating with consumers, and concludes with reflections on the workshop presentations and discussions by members of the roundtable and its chair. Further information is provided in the appendixes, the workshop agenda (Appendix A), workshop speaker biosketches (Appendix B), and testimony provided by the organization America's Health Insurance Plans (AHIP) (Appendix C).

Although health literacy is commonly defined as an individual trait, it does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals' capacities and the health literacy-related demands and complexities of the health care system. Specifically, the ability to understand, evaluate, and use numbers is important to making informed health care choices. Health Literacy and Numeracy is the summary of a workshop convened by The Institute of Medicine Roundtable on Health Literacy in July 2013 to discuss topics related to numeracy, including the effects of ill health on cognitive capacity, issues with communication of health information to the public, and communicating numeric information for decision making. This report includes a paper commissioned by the Roundtable, "Numeracy and the Affordable Care Act: Opportunities and Challenges," that discusses research findings about people's numeracy skill levels; the kinds of numeracy skills that are needed to select a health plan, choose treatments, and understand medication instructions; and how providers should communicate with those with low numeracy skills. The paper was featured in the workshop and served as the basis of discussion.

While health literacy is a relatively new multidisciplinary field, it is vital to the successful engagement with and communication of health with patients, caregivers, and the public. This book ‘New Directions in Health Literacy Research, Theory, and Practice’ provides an introduction to health literacy research and practice and highlights similar scholarship in related disciplines. The book is organized as follows: the first chapter explains the still-evolving definition of health literacy; the next three chapters discuss developments and new directions in health literacy research, then a further two chapters are devoted to developments and new directions in health literacy theory. Two chapters explore health literacy interventions for vulnerable populations; four chapters cover health literacy leadership efforts; six chapters describe developments and new directions in disciplines that are similar to health literacy; and six chapters portray diverse health literacy practices. A preface from Richard Carmona M.D., the former U.S. Surgeon General, is included in the book. Although the book is intended primarily for health literacy researchers, practitioners and students, the diverse topics and approaches covered will be of interest to all healthcare and public health researchers, practitioners, and students, as well as scholars in related fields, such as health communication, science communication, consumer health informatics, library science, health disparities, and mass communication. As Dr. Carmona concludes in his preface: ‘This is essential reading for all health practitioners.’

Since the passage of the Patient Protection and Affordable Care Act (ACA), health care reform has created major changes in the U.S. health care system. The ACA has brought millions of people into the system who had no previous access, and many of these newly enrolled individuals have had limited experience navigating the complex and complicated U.S. health system. In July 2016 the National Academies of Sciences, Engineering, and Medicine convened a public workshop to examine health insurance through the lens of health literacy, focusing on literacy related barriers to information and coverage as well as on possible solutions. Participants discussed the role of health literacy in accessing health care and remaining in treatment; delivery and financing system reforms that affect organizational health literacy; and quality and equity considerations. This publication summarizes the presentations and discussions from the workshop.

Positive Mental Health for Children and Adolescents: Fighting Stigma and Promoting Resiliency examines the main mechanisms involved in improving mental health in children and adolescents, including social and biological processes, as well as effective treatments. By taking into account diverse settings and cultures, the book combines academic, research, and clinical contributions and sets forth how it can be translated into effective clinical practice. In addition, the book promotes the study, treatment, care, and prevention of mental and emotional disorders and disabilities involving children, adolescents, and their families, and includes emerging knowledge on mental health problems and good practice in child and adolescent psychiatry as relayed by experts from around the world. Focuses on the empirical evidence base for work in child and adolescent mental health Appraises the available evidence and underscores where it is lacking Demonstrates the implementation of research into practice Highlights the relevance of existing knowledge for clinical management Considers service and policy implications

The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy conducted a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health literate approaches. The goal of the workshop was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions. This publication summarizes the presentations and discussions from the workshop.

Covering the nurse’s role in promoting community health, Community/Public Health Nursing, 6th Edition provides a unique ‘upstream’ preventive focus and a strong social justice approach in a concise, easy-to-read text. It shows how you, as a nurse, can take an active role in social action and health policy – especially in caring for diverse and vulnerable population groups. Written by community health nursing experts Mary A. Nies and Melanie McEwen, this book offers clinical examples and photo novellas showing how concepts apply to the real world, and describes the issues and responsibilities of today’s community and public health nursing. UNIQUE! ‘Upstream’ preventive focus addresses factors that are the precursors to poor health in the community, addressing potential health problems before they occur. UNIQUE! Emphasis on community aspects in all steps of the nursing process highlights the community perspective in all health situations. UNIQUE! A ‘social justice’ approach promotes health for all people, including vulnerable populations. UNIQUE! Photo novellas use photographs to tell stories showing real-life clinical scenarios and applications of important community health nursing roles. Research Highlights boxes show the application of research studies to the practice of community nursing. Clinical examples offer snippets of real-life client situations. Case Study: Application of the Nursing Process feature presents practical and manageable examples for the theory, concepts, and application of the nursing process. Ethical Insights boxes highlight ethical issues and concerns that the community/public health nurse may encounter. Objectives, key terms, and chapter outlines at the beginning of every chapter introduce important concepts and terminology. NEW and UNIQUE! Veterans' Health boxes present situations and considerations related to the care of veterans. UPDATED Economics of Health Care chapter addresses the latest changes related to health care reform. UPDATED Healthy People 2020 boxes include the most current national health care objectives. UPDATED Communicable Disease chapter covers current public health surveillance and outbreaks of emerging health threats, including emerging infections (e.g., H1N1, SARS, West Nile virus).

Since the passage of the Patient Protection and Affordable Care Act (ACA), health care reform has created major changes in the U.S. health care system. The ACA has brought millions of people into the system who had no previous access, and many of these newly enrolled individuals have had limited experience navigating the complex and complicated U.S. health system. In July 2016 the National Academies of Sciences, Engineering, and Medicine convened a public workshop to examine health insurance through the lens of health literacy, focusing on literacy related barriers to information and coverage as well as on possible solutions. Participants discussed the role of health literacy in accessing health care and remaining in treatment; delivery and financing system reforms that affect organizational health literacy; and quality and equity considerations. This publication summarizes the presentations and discussions from the workshop.